Healthcare Provider Details

I. General information

NPI: 1508850793
Provider Name (Legal Business Name): HDK ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 12/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 MAIN ST SUITE 210
HOUSTON TX
77030-4456
US

IV. Provider business mailing address

7700 MAIN ST SUITE 210
HOUSTON TX
77030-4456
US

V. Phone/Fax

Practice location:
  • Phone: 713-660-8888
  • Fax: 713-661-4828
Mailing address:
  • Phone: 713-660-8888
  • Fax: 713-661-4828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number14797
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number14797
License Number StateTX

VIII. Authorized Official

Name: MR. AMIT JAIN
Title or Position: CEO
Credential:
Phone: 713-660-8888